Cancer History Worksheet & FAQ
Cancer History Worksheet
Use this quick checklist of hereditary cancer characteristics to find out if you should further investigate your genetic risk for cancer. Note any of the bullet points that pertain to you or your family’s health history.
Potential Risk Factors:
- Any cancer diagnosed <50
- Cancer in more than one generation in your family
- Two or more different types of cancer in same individual (e.g. breast and ovary)
- Any male relative with breast cancer
- Any relative with a rare cancer (e.g. pancreas, kidney)
If any of the risk factors above pertain to you, the Cancer Genetic Risk Assessment Program can help determine whether you may be at an increased risk for developing cancer due to an inherited predisposition and help you identify ways to lower your risk.
Frequently Asked Questions
How can the program help me?
If you have a personal or family cancer history and are worried about cancer risks for yourself or your loved ones, a comprehensive assessment of your medical and family history helps identify whether the cancer may be genetically inherited. Most cancers are not hereditary, however, by understanding cancer risks, you can take steps to reduce risk through education and screening, helping to prevent the occurrence or recurrence of cancer.
Why should I learn about my cancer risks?
Understanding more about your personal and familial cancer risk can help you make more informed health care decisions, and may help your physician provide you with specialized screening and prevention options to further reduce your cancer risks.
What happens at my first appointment?
At your first appointment you meet with the genetic counselor. The counselor conducts an in depth review of your medical and family history. You will also meet a medical oncologist with whom you can address any questions regarding further screening tests, diagnostic procedures, treatment protocols, and other medical issues.
After careful medical and family history evaluation we determine whether genetic testing is appropriate. If indicated, further genetic testing is offered. It is important to know that all testing is voluntary. Should you decide that further genetic testing is right for you, we help facilitate testing and support you in this process, as well as offer appropriate and helpful
resources and referrals.
What do I need to bring to the appointment?
Once you call for your appointment a Medical Questionnaire & Family History Questionnaire will be mailed to you. Please complete the forms and fax (415-600-5975) or mail the questionnaires back to us at least one week prior to your appointment. The accuracy of our assessment is dependent on information you provide; therefore, we encourage you to make every effort to complete the questionnaires in full. If additional medical records are required you will be notified.Fax: 415-600-5975
Mailing address:
California Pacific Cancer Genetic Risk
Assessment Services
Pacific Campus – Stanford Building
2351 Clay Street, Suite 513C
San Francisco, California 94115
How do I get more information?
If you have further questions please contact the Cancer Genetic Risk Assessment Program at 415-600-5961. The genetic counselor is available to help with any questions or concerns you may have and sor appointment scheduling. Physician referral forms can be faxed to 415-600-5975.Directions
Cancer Risk Assessment Program is located on the Pacific Campus – Stanford Building, 2351 Clay Street, Suite 513C San Francisco, California 94115
See: Directions and maps to Pacific Campus | Finding your way on Pacific Campus